| NPI | 1790834984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 002879) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E59116) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-07-14 |